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Pulmonary Med

Pulmonary Meds shortened

Glucocorticoids Vancenase, Flonase, Nasonex, Nasocort & Pulmicort
Leukotriene Modifiers Singulair & Zyflo
Methylxanthines theophylline
Beta 2 Adrenergic Agents Xopenex, Albuterol, Serevent, Advair
Oral Anti-histamines Benadryl, Tavist, Chlor-trimeton, Claritin, Zyrtec, Allegra, Clarinex
Decongestants Sudafed, Dristan, Neo-synephrine
Anticholinergic Spiriva & Atrovent
Coughing Codeine, Dextromethopan, Mucinex & Mucomyst
Antifungal Amphotericin B, Azoles (Diflucan, Sporanox, Vfend
Antimetabolites Trimethoprim & Sulfonamides
Penicillins Pipracil, Zolsyn, Augmentin, Penicillin G
Cephalosporins Maxipime, Rocephine, Cefzil, Cefazolin
Carbapenems Primaxin
Tetracyclines Doxycycline & Tetracycline
Macrolides Biaxin & Zithromax
Aminoglycosides Gentamycin
Fluoroquinolones Cipro & Levaquin
Azoles Diflucan, Vfend, Sporanox
TB Meds INH, Rifadin, PZA & myambutol
Chemo Agents Taxol & Paraplatin
Vancenase, Pulmicort, Flovent/Flonase, Nasonex, Nasocort Most effective antiasthma drug. S/E: with chronic use: adrenal suppression, bone loss, oropharyngeal candidiasis & dysphonia, hyperglycemia, displacement of fatty tissue, decreased healing
Nasonex & Nasocort Intranasal. S/E: drying of nasal mucosa, burning/itching, sore throat, epistaxis, not as effective if nasal congestion is present
Zyflo blocks leukotriene synthesis; used for adults and kids >12; hepatotoxic, monitor ALT, competes with theophylline, coumadin
Singulair Leukotriene receptor blocker; used prophylactically & maintenance; prevention of exercise induced bronchospasm; relief of allergic rhinitis; not immediate or hepatotoxic
NasalCrom (Intranasal), Intal (Inhalation) Effective for seasonal allergy attacks, and exercised induced bronchospasm, give 15 min before. Decreases bronchial inflammation, not a bronchodilator. Used prophylactically, not quick relief, no systemic effects, can be used instead of steroids
Theophylline causes bronchodilation; narrow therapeutic range. Given PO. Wide variations in metabolic rates = therapeutic is 5-15, levels 20-25 cause nausea, vomiting, restlessness; >30 dysrhythmias (Vfib) and seizures. Avoid w/ caffeine. Not commonly used
Albuterol & Xopenx (short acting Beta 2 Adrenergic Agonist) Given inhalation, immediate effect, peaks 30-60 mins, persist for 3-5 hrs. If used for exercise induced bronchospasm take 15 min before. S/E: increase HR, agina, tremor
Serevent (long acting Beta 2 Adrenergic Agonist) Given PO or inhalation q12 hrs; not first choice for attack, not to be used alone - use w/ steroid. Onset begins 10-30 minutes
Advair Combo Beta 2 Adrenergic Agonist
Chlor-Trimeton, Benadryl, Tavist (1st Generation oral antihistamines) Relieves rhinorrhea, sneezing, nasal itching, but NOT congestion. Take on a regular basis. S/E: sedation, dry mouth, urinary hesitancy, constipation due to anticholinergic effects
Zyrtec, Allegra, Claritin, Clarinex (2nd Generation oral antihistamines) Relieves rhinorrhea, sneezing, nasal itching but not congestion. Take on a regular basis. S/E: few, NO SEDATION
Neosynephrine, Sudafed, Dristan (Decongestants) Decrease nasal congestion by vasoconstricting, shrinks swollen membranes. Used for allergic rhinitis to relieve stuffiness. S/E: rebound congestion, limit 3-5 day use, CNS excitation, restless, anxiety, watch cardiac patients
Sudafed Can be converted to methamphetamine, must be kept behind counter
Atrovent Onset 30 seconds, max 3 min. Lasts up to 6 hrs. S/E: dry mouth, irritation of pharynx, avoid if peanut allergy
Spiriva Long acting, onset 30 minutes, peak 3 hrs, lasts 24 hrs. Given 1x daily. S/E: dry mouth, DPI, additive benefits w/ Beta 2
Codeine Decreases frequency/intensity of cough; low dose, 1/10 of dose used for pain; potential for abuse
Dextromethophan Non-opiod antitussive; taken at high doses can cause euphoria
Mucomyst Given by inhalation; watch for bronchospasm, contains sulfur
Mucinex & Mucomyst Expectorant stimulates flow of respiratory secretions, mucolytics breaks up mucus
Penicillin G active against most gram + bacteria, most gram - are resistant. Given IM or IV, intra arterial injection can produce severe reactions (gangrene, necrosis) must AVOID
Pipracil Broad spectrum, given IV, decrease dosing for impaired renal function.
Zosyn Contains tazobactam which is a beta lactamase inhibitor (prevents the bacteria's beta lactase enzyme from breaking down the antibiotic which is piperacillin)
Augmentin May be given orally; S/E: rash & diarrhea. Clavulanate is a beta lactamse inhibitor protecting the amoxocillin from the bacteria's beta lactamase enzymes
Cefazolin Destroyed by beta lactamase enzymes; used for gram +. Binds to PCN binding proteins; has a beta lactam ring, bactericidal; most effective against bacteria undergoing cell division and growth. Given IV/IM
Cefzil & Ceftin Less sensitive to beta lactamase enzymes. Does not reach CSF. Used for active infection; prophylactically w/ surgical patients
Rocephin & Maxipime Highly resistant to beta lactamases. Reserved for active infections, strong antibiotics "BIG GUNS"
Cephalosporins S/E: hypersensitivity reactions. Rash for several days after onset of use, risk for bleeding (interferes w/ Vit K metabolism), thrombophlebitis. Usually given IV/IM - eliminated by kidneys
Rocephin Do not mix w/ calcium containing IVF/IVPB
Primaxin Very broad spectrum, beta lactamase antibiotic given IV only. Binds to PCN binding proteins, resistant to many beta lactamases; penetrates gram - outer membrane. Penetrates CSF, elimination by renela. S/E: N/V, diarrhea, hypersensitivity
Vancomycin Should be reserved for serious infections (CDIFF, MRSA, allergy to PCN). S/E: nephrotoxic, ototoxic (ringing in ears, hearing loss). Rapid infusion may cause "Red man syndrome". Do peaks & troughs
Azactam Contains beta lactam ring. Binds to PCN binding proteins, NOT effective against anaerobes or gram + bacteria. S/E: pain & thrombophlebitis at injection site. Treats gram - aerobic bacteria. Given IM/IV
Tetracycline Take on empty stomach, eliminated by kidneys, avoid w/ renal failure. Take w/ full glass of water, use straw/avoid contact w/ teeth. Treats: chlamydia, lymes diase, h pylori, acne
Doxycycline Can take w/ food, eliminated by liver, OK to use w/ renal failure. S/E: discolors teeth. Treats: chlamydia, lyme's disease, h pylori, acne
Biaxin Used for resp tract infections, h pylori, pertusis, whooping cough, diptheria, chlamydia, some pneumonia. S/E: GI Upset, QT prolongation
Zithromax Treats respiratory infections, chlamydia, pertusis, whooping cough, diptheria, chlamydia, some pneumonia. Absorption increases w/ food.
Cleocin Used for severe Group A strep infections. S/E: pseudomembranous colitis, CDIFF (profuse watery diarrhea, abdominal pain, fever, leukocytosis, stools positive for mucus and blood)
Zyvox Used for VRE, MRSA, gram + bacteria. S/E: myelosuppression AKA decreases WBC, RBC, platelet
Gentamycin Used for Aerobic gram - bacilli, cannot kill anaerobes, need O2 to transport medication across membrane. Given IV only, may give PO for bowel infection only. S/E: ototoxic, nephrotoxic, monitor peaks & troughs
Cipro & Levaquin Used for respiratory, urinary, GI, bone, joints, skin & soft tissue infections. S/E: tendon (achilles) rupture, GI upset, candida of pharynx and vagina. CNS - dizziness, confusion. Absorption decreases w/ Al, Mg, Fe, Ca, dairy
Flagyl Used for CDIFF, abdominal and vaginal surgery, h pylori. S/E: metallic taste, darkening of urine, nausea, headache, dry mouth. Avoid alcohol, may need to decrease alcohol
Amphotericin B Active against broad spectrum fungi. Premedicate w/ Benadryl & tylenol, corticosteroids. Renal impairment occurs in almost all patients; avoid other nephrotoxic drugs, bone marrow suppression. BIG, DANGEROUS DRUG
Sporanox Take with food, do not take w/ antacids. Broad spectrum anti-fungal
Diflucan, Vfend, Sporanox Broad spectrum anti-fungals. Given PO. Used for blastomycosis, histoplasmosis, candidiasis. S/E: cardiosuppression and liver injury
Cancidas Used for aspergillus or candida only. Given IV. S/E: phlebitis. Better tolerated than Ampho B
INH Bactericidal to actively dividing organisms. Must be taken for 6 mos prefer 9. S/E: liver damage, peripheral neuropathy due to lowered vit B6
Rifadin Bactericidal to TB. Take on empty stomach. S/E: Red,orange discoloration of urine, sweat, tears, saliva
PZA Bactericiidal to TB, hepatotoxic, increases uric acid
Myambutol Bacteriostatic, used to treat TB resistant to INH or Rifadin. S/E: optic neuritis (blurred vision, constriction of visual field, changes to color discrimination), inhibits uric acid excretion
Zovirax Active only against herpes virus family (chicken pox, herpes, shingles).
Paraplatin Used for small cell lung cancer. S/E: bone marrow suppression, nausea, vomiting. Nephrotoxic, watch for hearing loss
Taxol Used for non small cell lung cancer. S/E: severe hypersensitivity infusion, bone marrow suppression, alopecia, bradycardia. Premedicate w/ Benadryl/corticosteroids.
Created by: kristyd02